Discuss about the Quality Maintenance in Healthcare.
The ministry of Health Department in New Zealand has focused their concern in the development of the quality of healthcare services that are provided to the different citizens of the nation. This initiative had been proposed after the health department had thoroughly analysed the needs of various patients who come to seek service at the healthcare sectors. The concerned ministry have placed importance on each and every stakeholder in the healthcare sectors including who works in the healthcare system, the persons who come to seek service form them and the system itself to commit their dedication to the development and improvement of quality in the services provided and received in the sectors (Gilmour et al., 2016).
The Ministry of healthcare dependent had set up a vision for the welfare of the citizens that include enhancement of the quality of the New Zealand healthcare sectors and the disability sectors. The ministry believes that it can be achieved by people cantered care and high quality and safe practices which should not only improve at a continuous rate but should be also culturally competent. They advise every stakeholder of the healthcare sectors to involve patients in the services they provide and at the same time be receptive and responsive to the demands of the patients’ needs and values (Healy, 2016). This will take into inclusion both individuals and groups of population as a whole.
They have mainly adopted a system approach because provision of healthcare service is complex and involves decision making skills and action occurring attributes within peoples, individuals, teams, organisations and also subsystems. This approach was found to be helpful in benefitting the patients which involved individual patients and their families as whole (Clifford et al., 2015).
It becomes extremely important to understand the proper meaning of the term quality before ensuring it in the healthcare services. Quality in this aspect can be defined as the degree which when successfully achieved in the service can ensure better survivability rate of patients, increasing likelihood of leading better lives, attaining desired health outcomes, encouraging patients with disability to become independent and participate in their treatments and feel themselves included in the treatment with proper education and current professional knowledge. This quality can be achieved only when proper interactions with fruitful results are possible within people, individuals, organisations, teams and systems (Gorman et al., 2015).
The main aspects on which the Ministry had paid importance in these contexts are maintenance of people centred approach that ensures maintenance of dignity and morals of the stakeholders involved. It also pays significance to the fact that every of the individuals should have equal access to healthcare services irrespective of their caste, creed, religion and ethnicity. Developments should also be taken so that equity can be maintained in healthcare services irrespective of their socio economic backgrounds to which the individuals or the groups belong to. Maintenance of safety in every of the practices along with paying importance to the evaluation of the effectiveness of the services should be ensured for quality development. These would ultimately help in the achievement of efficiency in the different skills and knowledge of the concerned staffs so that the best quality service can be provided. All the important aspects were proposed by the Ministry to be dependent on the most valuable foundations of three important principles governing partnership, participation and protection maintained as the Treaty of Waitangi (Gauld & Horsburg, 2014).
Quality assurance activities mainly focused not only on maintenance of quality but also on quality improvements. This activities followed approaches which included the clear explanation of concern of quality which should be vested in teams. It also included proper monitoring and evaluation of the quality that is being exhibited through services. This would in turn help in further modifications if needed. Paying significance to the improvement of services to achieve desired outcomes should be the motto of each individual and also as a team (Dyall et al., 2014). Moreover they should also take initiatives which would help them to develop systems and invest in people with an aim of achieving outcomes in health which are of high quality.
The goals of the system approach involved maintenance of special relationship with the Maori providing values to the principle of the treaty of Waitangi and exhibiting high quality leadership traits for maintaining service quality improvements taking Maori aspirations and priorities in mind. People were expected to take part in planning, delivery and assessment in healthcare services involving participation of Maori, spreading awareness, evolutionary redesigning of systems, building trustworthy relationships with all participants and many others. Motivational environment should be encouraged containing cultural competency tools; using knowledge including Maori satisfaction was proposed to support quality conscious culture (“Improvement Quality System Approach”, 2017).
A number of standards were also initiated nationwide for quality assurance programmes like the Health and Disability Commissioner (Code of the Health and Disability Services Consumers’ Rights) Regulations 1996, National Screening Standards and the Health Practitioners Competence Assurance Bill and others. Funding came from the DHBs which are responsible for services with advisory committee including the Mortality Review Committees and National Health Epidemiology and Quality Assurance Advisory Committee.
Since the time of 1983, the New Zealand health sectors have gone through a number of four structural transformations. In course of time, with each change, new organisations have come forward to help in funding. The first one was the 1983-1993 Area Health Boards (AHBs) which was followed by 1993-1997 Regional Health Authorities (RHAs) as well as Crown Health Enterprises (CHEs). Moreover there were instances when 1998-2001 Health Funding Authority (HFA) was also witnessed. Hospital and Health Services (HHSs) also helped. 2001 District Health Boards (DHBs) had been seen as well (“New Zealand Health System Reforms”, 2017). All of them have helped in achieving health outcomes and also helped in increase of efficiency and accountability. They also helped in reduction of health expenditure. If one looks over the activities of 200, the main body of work was the District Health Boards called the DHB. This age mainly saw the 21 DHBS that was established along with the centralisation of health funding with MOH. Emphasis was based on preventive health services. PHOs were established in 2002 and were funded by DHBs. In October 2007, low care practices were introduced that were backed up with governmental subsidies with free service for children under six. Presently there are 82 PHOs having 4 million enrolees. The practices done by GP vary between PHOs and their own practices and are monitored by DHBs and as well as independent Fee Review Committee (“New Zealand Health System Reforms”, 2017). Fees of GPs are published under the guidance of DHBs and also on PHO websites. Recently not for profit organisations have also come to scenarios along with community organisations, third party organisations looking after the Maoris.
Fig: Different important bodies involved in proper monitoring and evaluation of healthcare services in New Zealand.
Source: (“New Zealand Health System Reforms”, 2017)
From the entire essay, it can easily be concluded that the system approach undertaken by the Ministry of Health in New Zealand in developing the quality of service in healthcare is thoroughly researched. It contains of many attributes which are not only evidence based but also ensures that they cover every prospect of healthcare systems required to ensure safe practice. They have included the principles of the treaty of Waitangi in each of the goals that they have set so that the entire nation can get the benefit and no one feels left out. They have incorporated important bodies into the plans which not only helped in funding but also helped in evaluations and monitoring mechanisms. Hence this initiative by the government is praiseworthy and if followed whole heartedly by every stakeholder, it can ensure better future for New Zealand healthcare systems.
References:
Clifford, A., McCalman, J., Bainbridge, R., & Tsey, K. (2015). Interventions to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA: a systematic review. International Journal for Quality in Health Care, 27(2), 89-98.
Dyall, L., Kepa, M., Teh, R., Mules, R., Moyes, S., Wham, C., … & Loughlin, H. (2014). Cultural and social factors and quality of life of Maori in advanced age. Te puawaitanga o nga tapuwae kia ora tonu-Life and living in advanced age: a cohort study in New Zealand (LiLACS NZ).
Gauld, R., & Horsburgh, S. (2014). Measuring progress with clinical governance development in New Zealand: perceptions of senior doctors in 2010 and 2012. BMC health services research, 14(1), 547.
Gilmour, J., Strong, A., Chan, H., Hanna, S., & Huntington, A. (2016). Primary health?care nurses and Internet health information?seeking: Access, barriers and quality checks. International journal of nursing practice, 22(1), 53-60.
Gorman, D. (2015). Developing health care workforces for uncertain futures. Academic Medicine, 90(4), 400-403.
Healy, J. (2016). Improving health care safety and quality: reluctant regulators. Routledge.
Improvement Quality System Approach. (2017). www.health.govt.nz. Retrieved 6 April 2017, from https://www.health.govt.nz/system/files/documents/publications/improvingqualitysystemsapproach.pdf
New Zealand Health System Reforms. (2017). www.parliament.nz. Retrieved 6 April 2017, from https://www.parliament.nz/en/pb/research-papers/document/00PLSocRP09031/new-zealand-health-system-reforms
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